Physicians at War

There are a range of ethical issues that confront physicians in times of war, as well

as some of the uses of physicians during wars. This book presents a theoretical

apparatus which undergirds those debates, namely by casting physicians as

being confronted with dual-loyalties during times of war. While this theoretical

apparatus has already been developed in other contexts, it has not been specifically

brought to bear on the ethical conflicts that attain in wars. Arguably, wars thrust

physicians into ethical conflicts insofar as these wars create a tension between a

physicianâEUR(TM)s obligation to heal and an obligation to serve some other good (e.g.,

military chain of command, national security, the greater good, etc.). Alternatively,

we can debate whether this conception is appropriate. For example, one could

argue that that non-medical duties cannot attach to physicians (e.g., due to nonoverlapping

spheres of justice), thus abrogating the dual-loyalty challenge. Or else

one could argue that these medically-trained personnel do not act qua physicians

at all (but rather partisan advocates) and therefore duties that would otherwise

attach to physicians do not attach here.

In the first part of this book, these issues are debated. In the second part of

the book, the dual-loyalities frame is used to explore various substantive debates

that obtain when the military makes use of physicians. Physician involvement

in torture is a heated topic, and certainly the most visible element of the debate.

Also, however, we could use the dual-loyalties framework to explore issues in

other arenas, such as: development of chemical and biological weapons, medical

neutrality/battlefield triage, and so on. In each of these cases, the same tensions

arguably exist: physicians have duties both to their patients and âEURoeelsewhereâEUR

(which, depending on the details of the view, could be any of the above-mentioned

ends).

Résumé
This paper offers a brief examination of ethical health issues arising from military operations and outlines which, if any, of these ethical health issues apply to current Australian Defence Force (ADF) military operations. The transparency of military operations provided through real time global media reporting and the Internet, has raised public awareness of incidents that can be viewed broadly as ethical issues or dilemmas. While many of these issues are not new, it is the changing context of post cold war military operations and scale and demand of humanitarian operations that places new requirements on how the ADF best addresses these potential issues before they become critical incidents. In identifying potential ethical issues arising from military health operations, it is recognized that military health personnel operate within a command and control organizational structure and associated culture. It is also recognized that the complexity of the issues and the environment within which military health personnel are expected to operate will raise ethical health issues not likely to be encountered to the same degree by those health practitioners operating in the average suburban practice or hospital, except when health personnel are confronted with large scale emergencies, such as those encountered with recent terrorist attacks and massacres.

Contenu

Physicians and Dual-Loyalties.- Physicians at War: The Dual-Loyalties Challenge.- Dual-Loyalty and Human Rights in Health Professional Practice: Proposed Guidelines and Institutional Mechanisms.- Guidelines to Prevent the Malevolent Use of Physicians in War.- Dual Disloyalties: Law and Medical Ethics at Guantánamo Bay.- Toward a Framework for Military Health Ethics.- Physicians and Torture.- Physician Involvement in Hostile Interrogations.- Indecent Medicine Revisited: Considering Physician Involvement in Torture.- Torture and the Regulation of the Health Care Professions.- Physicians and Weapons Development.- Is Medicine a Pacifist Vocation or Should Doctors Help Build Bombs?.- The Case Against Doctor Involvement in Weapons Design and Development.- Armed Conflict and Value Conflict: Case Studies in Biological Weapons.- Ethics and the Dual-Use Dilemma in the Life Sciences.- Physicians on the Battlefield.- Triage Priorities and Military Physicians.- Medical Neutrality and Political Activism: Physicians' Roles in Conflict Situations.